Structural constraints and opportunities for CAM use and referral by physicians, nurses, and midwives

This article examines the attitudes and reported behaviors of physicians, nurses, and midwives regarding complementary and alternative medicine (CAM), with respect to one key theme that emerged from a broader qualitative study. Of central interest are the structural influences identified by study participants that either act as constraints or opportunities for their professional use of or referral for CAM. In an effort to interpret these results, the analysis is situated within the sociology literature that documents the influences of professional socialization, practice philosophy, regulation, and organizations on professional behavior. These influences are classified as either professional-level structures or work/organizational structures. The main conclusion is that future research should pay more attention to such structural dimensions that may be exerting influence on the decisions of providers about whether or not to professionally use or refer for CAM. This article is offered as a conceptual starting point for doing so.